This is the third and final article in our deep-dive series on the Belém Health Action Plan. In this article, we provide an overview of BHAP, the third action line, paths ahead, and key questions for implementation.

If you'd like to read more about the action plan, check out our other articles about action line 1 and action line 2.

Overview of the Belém Health Action Plan

The Belém Health Action Plan is a significant global effort to align health systems with the realities of a changing climate. It sets the objective that the health sector must strengthen its climate adaptation and resilience, aiming to anticipate and respond to climate-driven health risks, rather than react once harm has already occurred. 30 countries and and 50 organizations have endorsed the plan and will report on their progress in 2028.

BHAP is organized around three lines of action:

1. Surveillance and monitoring: understanding how climate is influencing health in real time
2. Evidence-based policies, strategies, and capacity building: strengthening institutions and decision-making
3. Innovation, production, and digital health: scaling the technologies and resilient systems needed for the future

Across all three action lines, the Plan emphasizes systems should be:

• Integrated: linking meteorological, environmental, social, and health datasets
• Interoperable: enabling information to move across agencies, sectors, and borders
• Inclusive and participatory: engaging communities, incorporating local and Indigenous knowledge, and centering vulnerable populations as cross-cutting principles
• Continuously evaluated: updated and refined as climate risks evolve and new data becomes available

Action Line 3: Innovation, production, and digital health

Action Line 3 addresses how health systems can strengthen their adaptive capacity and continuity of care in the face of climate change by investing in innovation, resilient production, and digital health systems. It emphasizes that climate change places increasing stress on health infrastructure, supply chains, and information systems, and that innovation and digital tools must be aligned with institutional capacity, governance, and public interest to be effective.

It proposes the following measures:

• Promote research, development, and deployment of climate-resilient health innovations, including technologies, services, and organizational models that support adaptation to climate-related health risks.
• Boost local and regional production capacity for essential health products (medicines, vaccines, diagnostics, medical equipment) to reduce dependence on vulnerable global supply chains and improve responsiveness during climate shocks.
• Improve the resilience and sustainability of health supply chains by integrating climate risk assessments, diversifying sourcing, and improving logistics and storage systems.
• Create and leverage open, interoperable, and secure data systems, enabling coordination across institutions and borders while safeguarding privacy and public trust.
• Expand digital health systems to support continuity of care, early warning, and data-informed decision-making during climate events.
• Reinforce strategic stockpiling and regional coordination mechanisms to ensure equitable access to essential health products, particularly for high-risk populations.

Design choices and pathways in action line 3

Action Line 3 could be interpreted (oversimplified) as a linear roadmap: invest in innovation, expand production, digitize health systems, and achieve resilience. But the impacts largely depend on navigating complexities and choices to find the right balance that shapes whether these investments strengthen health systems over time or introduce new vulnerabilities.

A few issues and complexities that we see:

Speed and staying power

Rapid deployment of digital tools and new technologies can improve response and preparedness in the immediate-term. But innovations that are introduced without sufficient institutional capacity, workforce readiness, or governance may be difficult to maintain, adapt, or scale as conditions change. Finding the right balance between moving fast and moving effectively is imperative for long-term resilience.

Efficiency and resilience

Highly efficient production and supply chains can reduce costs and improve availability, but can also lack redundancy and flexibility. Climate-related disruptions may expose the limits of efficiency-driven systems, especially when single points of failure emerge. Ensure careful consideration of when diversification, buffer capacity, and regional production should be prioritized, even if they appear less efficient in the short term.

Data use and data stewardship

Digital health systems increase the volume and availability of critical health data. But without clear rules for data access and ownership, these systems can undermine trust and institutional accountability. Effective data stewardship and governance requires treating health data as a public responsibility and digital commons.

Key questions for implementation

It's important to evaluate how these elements are introduced and governed. Here are some questions that can help guide development and implementation:

• Do public institutions retain decision-making authority over digital systems and data, or is this control effectively outsourced?
• Are digital health systems designed to work together and evolve?
• How is local or regional production sized and located to improve resilience?
• Are there enough skills and capacity to operate the tools and systems being created?
• Are communities and frontline workers involved and centred in defining needs and evaluating outcomes?
• Are climate risks explicitly incorporated into supply chain planning, infrastructure design, and digital health use cases?

These questions shouldn't determine whether to proceed, but rather how to ensure that actions and policies will achieve the right goals and objectives, and create systemic resilience.

Conclusion

Climate-resilient health systems can't be built through emergency response alone. Innovation, production capacity, and digital health will play an increasingly central role in determining whether these systems can anticipate climate risks and adapt.

At the same time, these tools and processes are not neutral. Their value depends on how they're governed, integrated into public institutions, and aligned with long-term resilience. As implementation moves forward, action line 3 offers a critical opportunity to treat innovation and digital health as public infrastructure designed for equity, resilience, and an turbulent climate future.

At Groundswell, we work with governments and partners to build climate-health data and digital systems as public infrastructure, designed for resilience, equity, and long-term stewardship.

Get in touch to learn more about how we support implementation of the Belém Health Action Plan in practice.